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Cycling Without Age Quantitative and Qualitative Study

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Cycling Without Age Quantitative and Qualitative Study CIVIL MONEY PENALTY (CMP) FUNDED PROJECT REPORT Grantee Miravida Living Campus 225 North Eagle Street Oshkosh, WI 54902 Project Title Cycling Without Age Quantitative and Qualitative Study Award Amount $67,372 Grant Period December 1, 2016-November 30, 2017 Additional Information and Resources Final Report Manual Cycling Without Age Video Department of Health Services / Division of Quality Assurance Quality Assurance and Improvement Committee This project report has been prepared by the author under a research grant from the Department of Health Services (DHS) Quality Assurance and Improvement Committee. The views expressed in the report/training are personal to the author and do not necessarily reflect the view of the Department of Health Services or any of its staff and do not bind the Department in any manner. F-01593A (03/2016) 1 Project: Cycling Without Age Prepared by: P. McNiel DNP, RN, APHN-BC and J. Westphal PhD, RN, NE-BC University of WI Oshkosh School of Nursing For further information and questions, please contact P. McNiel at 920-424-3089 2 Abstract (Project Objective) The purpose of this study is to examine the impact of the Cycling Without Age (CWA) program introduced to enhance the quality of life in persons living in nursing homes on the Miravida Living (ML) campus. Program participants will spend more time outdoors, enjoy touring the community in rickshaws, and develop intergenerational relationships with their pilots (rickshaw drivers). The CWA program will help to dispel uninformed beliefs held by individuals not familiar with elders and nursing home life. It will strengthen ties between nursing home residents and the greater community. CWA is designed to provide residents with rides as one to two individuals sit in a specially designed rickshaw attached to the front of a specially designed bike driven by volunteers and staff trained to be rickshaw pilots. Benefits of the Cycling Without Age program are consistent with the Healthy People 2020 mandate "to improve the health, function, and quality of older adults." Funding was requested and approved by the State of Wisconsin Department of Health to measure outcomes of the program and support development of CWA programs in nursing homes across the state. Quantitative and qualitative studies confirmed the positive impact of the program nursing home residents, pilots and staff. 3 Background The purpose of this study is to conduct an analysis of the effectiveness of the Cycling Without Age (CWA) program. The program was founded by Ole Kassow in 2012 in Copenhagen, and has taken off worldwide. It pairs volunteers and staff piloting rickshaws and elders living in nursing homes interested in going for a ride and spending time outside. The program’s moniker is The Right to Wind in Your Hair. CWA provides individuals living in nursing facilities to experience a better quality of life. Program participants spend more time outdoors, enjoy touring the community in rickshaws, and develop intergenerational relationships with rickshaw drivers called pilots. The program has created ties between elders and volunteers, effectively illustrating a model for sustainable collaboration between long-term care facilities and the greater community. Limited research has been done in this area since rickshaw bike rides are new to the elder care field. In one manuscript, the focus was on community collaborative efforts to initiate a new elder care recreational activity for long-term care residents (Sorensen & Torfing, 2015). Other biking studies focused on the aspect of the older adults actually going out and biking themselves versus riding in a rickshaw (Zander, Passmore, Mason & Rissel, 2013). Fitzsimmons (2011) actually developed evidenced-based guidelines for wheelchair biking to treat depression in long-term care residents. The State of Wisconsin Department of Health provided funding to measure outcomes of the CWA program and support the development of the program in all types of nursing home settings across the state of Wisconsin. Grantee is the first licensed program in the United States. Methods Researchers used a mixed methods approach to study the impact of the CWA program. Qualitative and quantitative data were collected. Researchers planned to identify the impact of the CWA program on residents, rickshaw pilots and staff. Specifically, researchers wanted to explore the impact of the CWA program on quality of life for nursing home residents. UWO researchers conducted qualitative interviews with rickshaw pilots and riders participating in the program to assess their personal experiences related to the Cycling Without Age program. Quantitative data was also collected using a demographic form, ride records, and quality of life questionnaire. Qualitative Method A single open-ended research question was explored with volunteers “tell me about your CWA bike ride experience.” Clarifying questions were asked as needed. Interview participants were rickshaw pilots and riders. Nursing home resident interviews captured the impact of their experiences while outside on a ride. Rickshaw pilots were individuals that might see the impact of the CWA program for residents participating in rickshaw rides. The program coordinator approached rickshaw pilots, riders, and staff with a verbal invitation to participate in the interviews. Contact information for researchers was provided. One researcher conducted interviews with residents and volunteers in a private room on campus. The interviews were recorded and transcribed; responses were kept confidential by the individual conducting the 4 interviews. Participants were also asked to complete a demographic form, ride experience survey, and a quality of life questionnaire. Qualitative Results A total of 27 qualitative interviews were conducted including 16 residents and 11 volunteer pilots (including some staff). Five themes were identified from the qualitative interviews with resident riders and pilots. For resident riders three themes were identified (a) breath of fresh air, (b) wave, chat and remember, and (c) sit back and relax. Two themes were identified for the pilots (a) change in frame of mind and (b) mental and physical rewards. Breathe of Fresh Air (Older Adult Rider-Nursing Home Resident) This theme highlighted the importance of being outside and enjoying nature. Direct quotes from the riders that support this theme include the following: “Get out and see part of the city and get a little fresh air”. “It's good to sit out and enjoy it, fresh air and sunshine.” “Just being able to breathe the air and, you know, get fresh air and see the sights. It's, it's just gorgeous, you know, looking at everything.” “Oh, you're out in the open and you're, you know, can feel the breeze and stuff. Feel the sun, how, how warm it is. And it makes you feel a lot better.” Wave, Chat and Remember (Older Adult Rider-Nursing Home Resident) This theme highlighted the importance of enjoying the interaction between the older adult rider and those they saw on the bike ride. It centers on the rider engaging in waving, chatting, and smiling to those they pass along the way and how they shared stories and reminisced with the volunteer pilot. Direct quotes from the riders that support this theme include the following: “Yep. Cause they'll, anybody you bump into that's riding in a rickshaw waves to you, and anybody that's cutting grass and that all stop and wave, say hi to you.” “Well it's enjoyable. You meet different people and hear about different things around town.” “So he brought her out the front porch, the little stoop they had, and we visited for a while. And, yeah, cause at our age you don't pass something by and not do something about it because who knows what tomorrow will bring for all of us at our age. You have to think a little differently than when you were younger. ...well, they were thrilled, a surprise to say the least. Here I am in a rickshaw.” 5 …”And I was just as surprised to see them and I was happy to see them, so, it was a lovely rickshaw and it was a lovely day to go out and I was so pleased that she would take the time to stop to see them cause I'd never get there otherwise. Saw two people I really treasured. So it was a fun ride.” “Oh, you see so many people, different people walking along the street. They wave at you.” Sit Back and Relax (Older Adult Rider-Nursing Home Resident) This theme highlighted the importance of being able to sit back and just enjoy the ride. It touched upon the impact the ride had on the older adult. Direct quotes from the riders that support this theme include the following: “I think it's something that should be enjoyed to the, enjoyment for all the people here. ... And it's, it's fun. There's no danger or no hazards or anything, but some of them don't want to leave home I guess. I don't know.” “I just really liked the whole experience. I like being able to just relax and just look around and see things, you know, just being out in the fresh air was, is good too.” “Right. Oh definitely different than a car. Yeah, there you just buzz by. Yeah this is great. It's, it's very interesting and I enjoy going.” “I like being outside and doing things. And it was something different and I can sit down and enjoy the fresh air.” Change in Frame of Mind (Rickshaw Pilot) This theme highlighted the perspective of the rickshaw ride from the pilot’s perspective. They shared how they noted a change in the older adult riders’ demeanor as they participated in rides. Direct quotes from the pilots that support this theme include the following: “The most exciting things that I’ve found were just the change in personality.” “And his face was the happiest I've ever seen him before that.
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